Brands of sildenafil

Sildenafil is the medical name for the active ingredient in Viagra tablets. The patent for Viagra held by the drug company Pfizer expired in June 2013. Since then a number of UK licensed brands of sildenafil have become available from various pharmaceutical manufacturers. These companies market sildenafil branded by their company names, e.g. Sandoz sildenafil, Mylan sildenafil, Accord, Actavis, Ajanta, Pfizer, Teva, Torrent, Dr Reddys, Bristol Labs, Zentiva, etc.
Information on current brands supplied by Dr Fox at foot of page.

Generic treatment

As long as doctors write prescriptions using the medical name of the active ingredient, sildenafil, and not a brand name, pharmacists are free to supply any one of the available sildenafil brands. This sort of prescribing, using the medical name not the brand name, is called generic prescribing. Sildenafil is sometimes called generic Viagra. It is more accurate to say Viagra is a brand of sildenafil, and that sildenafil is the generic name.

Prices of sildenafil

Sildenafil is relatively cheap to produce, each tablet costing only a few pence to make. Pharmaceutical companies supplying sildenafil – since the patent of Viagra expired – now compete mainly on price and prices have come down dramatically. There is not much to choose in terms of wholesale price from one of the new producers of sildenafil to another, but compared with pre-patent expiry, prices have fallen a lot. The wholesale price is the price pharmacies pay. Patients pay a considerable mark-up, which varies from one pharmacy to another. Some online suppliers are much lower cost than others (compare prices of sildenafil).

The original brand of sildenafil from Pfizer, Viagra, is still available, but at the same high price as before, despite its market share shrinking. It remains popular only with men who can afford the original and who are reluctant to switch. Pfizer have also launched a generic sildenafil product as well.

Levitra (vardenafil), Cialis (tadalafil) and the newer tablet Spedra (avanafil) are alternatives to sildenafil, but are all still under patent and are considerably more expensive.

Benefits of low cost treatment

Erectile dysfunction (ED) treatment is now affordable to more men than before. The market in fake ED treatments from unregulated overseas websites has reduced and the NHS has increased the availability of treatment. These are welcome changes for men with ED who previously faced high prices, or cheap and potentially dangerous supplies from illegal websites, or severe restriction and rationing on the NHS.

Some have argued that low cost ED treatment is not a good thing. They suggest it will encourage recreational rather than therapeutic use. Those familiar with the treatment of ED through online clinics have not noticed a change in requests for treatment. The vast majority of men who take tablets for the treatment of ED do so for genuine medical reasons. The tablets usually work well to relieve a potentially distressing condition.

Dr Fox provides sildenafil tablets from £1.50 each following an online consultation.

Are all brands of sildenafil the same?

Sildenafil is a molecule with a structure that remains the same from one brand to another. The way it is absorbed into the bloodstream, works in the tissues, its side-effects and the way it is metabolised are always the same.

All the companies supplying sildenafil produce it in the same strengths and quantities, 25mg, 50mg, and 100mg tablets in packets of 4 (and also usually packets of 8 tablets). The packaging and information leaflets supplied with the tablets are similar from one brand to another. What varies is the shape, colour, size, and consistency of the tablets. Some are white and chalky, others are blue hard and smooth. Some are scored and can be easily divided, others are not. These differences are cosmetic, not differences in the active ingredient.

One sildenafil tablet of the same strength should be very much like another. Each will contain the same amount of the active ingredient. If the brand has a UK license, it will have been subject to the same standards of production and safety checks.

All medicine sold by UK pharmacies is required to be ‘UK licensed’, meaning quality checks have been carried out on each batch produced to ensure bioequivalence. This ensures both branded and generic versions contain the same active ingredient at the same level, and for all intents and purposes are the same medicine. Regulatory definitions of bioequivalence do allow for a small margin of difference.

Where tablets contain the same active ingredient medical professionals take it for granted that the effectiveness of each will be the same. There have been no studies to check the effect of one brand compared with another. Studies of this type are not normally carried out. They are difficult to do, requiring large numbers of men to be tested, and from a medical point of view there is no obvious reason to undertake such studies.

Brand preference

Patients become used to their tablets. They become familiar with the size, shape, colour, texture, and taste of their tablets. They know from previous experience what to expect when they take a particular tablet. By and large, they don’t like to change to a new brand of tablet, no matter whether they know the active ingredient is the same or not. It is reasonable for men with erectile dysfunction, or any medical condition, to take this approach, even if medical professionals find it inconvenient.

If a person knows their tablet they know what to expect. It is largely a matter of confidence, and confidence in the medicine can be a factor in a successful outcome for the patient. Of course there can be many reasons why erectile dysfunction drugs do not work on any given occasion.

Sandoz sildenafil for example is blue in colour, small, hard, and scored. On the face of it, Accord sildenafil, which is white and chalky, does not look as if it will do the same job, and no amount of explanation is likely to change this perception.

If patients have a particular brand preference please send a message with your order and we will endeavour to supply that brand if available.

Supply issues

Problems arise when brands go out of stock. It is perhaps surprising that pharmaceutical companies are fairly frequently unable to fill wholesale orders from pharmacies, but it happens quite a lot. The supply chain for medicines is long and complicated, and drugs are sometimes produced in small batches. Whatever the reason, shortages are the bane of patient’s and pharmacist’s lives. Patients tend to be sceptical when told a medicine is out of stock. Pharmacists end up ringing around suppliers to see what can be done, or even borrowing from other pharmacies.

When men are supplied with a brand with which they are not familiar it is easy to wonder if it is not working as well, or if the side effects are different. These concerns are common when the appearance of a medicine changes. It happens in lots of areas of medicine, from asthma and hay-fever to blood pressure treatment and ED.

Sildenafil from Dr Fox

Until recently Dr Fox supplied Sandoz sildenafil almost exclusively. Most men seemed to get on well with it. Sandoz came as a quarter-scored tablet, which could be broken to produce the desired dose. Now Sandoz is not available, we usually supply sildenafil from Torrent, Zentiva, Mylan, Bristol Labs, Dr Reddys or Ajanta, but often without explaining the change. In the future, if we need to substitute brands, we hope better explanation will allay some of the concerns and reduce customer queries.

Latest supply update – 17 October 2016
Dr Fox currently supplies Mylan and Torrent brands of sildenafil tablets (all strengths) for UK patients – both brands well reviewed. Torrent tablets are scored and can be split. Teva and Actavis brands can usually be ordered on request. All brands supplied UK licensed.International:TEVA and Actavis brands only are authorised for posting outside the UK (why?).
From £1.50 per tablet.